Article Text

39 Is it time to revisit the red flag referral system?
  1. RAJ Spence,
  2. ADR Spence,
  3. E Mackle
  1. General Surgical Unit, Craigavon Area Hospital, Craigavon, UK


Background The ‘red flag referral’ system is currently under stress due to the number of suspected cancer referrals. There are guidelines from the Northern Ireland Cancer Network regarding specific criteria for what constituents a red flag referral.

Aim To assess the efficacy of the 31- and 62 day referral pathways over a 1 year period for both upper and lower gastrointestinal cancers in a district general hospital.

Method All upper and lower GI suspected cancer referrals were assessed over a 1 year period (October 2015 – September 2016). Both 31 day and 62 day referral pathways were analysed following investigation. Data were obtained from cancer trackers.

Results For suspected Upper GI cancers, there were 2629 (1109 31 day in-hospital referrals; 1520 62 day general practice referrals) referrals over the 1 year period. There were 164 confirmed cancers (overall 6.24%, 31 day: 9.64%, 62 day: 3.75%). For lower GI cancers, there were 3951 (1299 31 day in-hospital referrals; 2652 62 day general practice referrals) referrals over the 1 year period. There were 188 confirmed cancers (overall 4.76%, 31 day: 9.62%, 62 day: 2.38%).

Conclusions There was a very low diagnosis of cancer from red flag referrals for both upper and lower GI symptoms. In the current environment of increasing demands on the NHS—is it time for current red flag referral criteria to be revisited?

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